How Trump’s aid cuts could cost lives in SA

LifeLine says most vulnerable HIV/AIDS patients already affected

Zoë Thomas

In a decision that has raised significant concern, President Donald Trump’s administration abruptly cut USAID funding for HIV/AIDS programs in South Africa.

A woman pictured going to a mobile clinic. Changes to funding will halt initiatives like this in the near future / Source: Africa Health Research Initiative

This move is expected to have dire consequences, with the potential to cost lives. According to LifeLine, a non-profit organisation actively providing counselling, skills training, and support for those affected by gender-based violence, children impacted by HIV/AIDS, and individuals needing mental health services, the loss of funding is a setback reminiscent of the crisis faced in 2001 when countless lives were lost due to HIV/AIDS.

“The effect of this funding being stripped away is that we will find ourselves in the same position we were in during 2001 when people in South Africa were really, really dying of HIV/AIDS,” said Sinikiwe Biyela, Executive Director of LifeLine.

“It’s sad that this is what will happen—and it won’t even take years. This will happen now.”

With the sudden loss of USAID funding, programs critical to health care are now at risk. Clinics that provide life-saving antiretroviral (ARV) treatments and mental health support are forced to scale back their operations, with some even facing possible closure.

Thousands of people—including women, children, and those living with HIV—are left in the dark about where to access essential resources. Although the South African government has pledged to send healthcare workers and extend ARV prescription periods to lessen the impact, many of these organisations have been struggling long before the funding cuts.

A brief look at their social media pages shows urgent requests for donations and volunteers to continue their work.

The withdrawal of USAID support has left them in a desperate scramble for solutions. Trump defended the cuts by stating that these programs were "misaligned with U.S. national interests and agency priorities."

Following this decision, a mass email dismissing USAID staff worldwide added to the crisis for organisations that relied on the agency's financial and logistical assistance.

“The impact of losing USAID funding is already being felt at the community level. We’ve had people come into our offices saying clinics don’t have ARVs. Some have even been told to get private prescriptions and pay for their own treatment,” Biyela noted.

HIV field workers filled a heavy gap in the health care system, with NGO doors forced to shut, many are left vulnerable/Source:The Borgen Project

To grasp the ground-level consequences of these cuts, we spoke with Biyela about the challenges ahead and the future for those they support.

How many people does LifeLine support?

“LifeLine has been funded by USAID for over 17 years, and our programs support over 13,000 children and youth. We assist vulnerable children and youth, including those affected by sexual abuse, HIV/AIDS, disabilities, and those acting as caretakers for adults facing economic hardship or abuse. Our work includes school programs that identify the need for HIV/AIDS training, skills development for GBV survivors, rape counselling, and community interventions. In terms of HIV/AIDS, our programs provide counselling, education, and treatment for individuals who might otherwise slip through the cracks of the public healthcare system.” Now, with funding removed, children who were able to return to school after acting as caregivers may be forced to drop out again. Individuals living with HIV, who depend on treatment and counselling, will encounter disruptions, which could significantly affect their health and raise the risk of further transmission. The psychological impact on the community is substantial.”

How are affected community programmes coping without funding?

“The termination of funding puts the people we serve in an extremely vulnerable position because our field workers' intervention is being impacted. It is through them that we identify abuse, HIV/AIDS cases, and poverty—determining how to intervene.” Without LifeLine's intervention, at-risk individuals may go unnoticed, and essential health and social services may no longer reach those in need. The repercussions extend beyond individual cases, jeopardizing broader efforts to combat gender-based violence, childhood poverty, and the HIV/AIDS epidemic in South Africa.

Why is sustained funding essential for programmes like LifeLine?

When we speak about funding, we cannot ignore the organisations that have already shut down. Knowing we could face the same fate in a few months is devastating—not just for us, but for the thousands of people we serve.” Non-profit organisations depend on funding not just for their programs but also for the people who carry out this critical work—field workers, counsellors, and social workers. LifeLine urges businesses, corporations, and banks to recognise their contributions to society and provide support. Public donations and volunteer efforts are equally important. “When we receive donations, every cent is accounted for. We ensure funds go where donors specify, and we operate with full transparency. But without sustainable funding, our ability to make a real impact is in jeopardy.”

Can you share a story of someone directly impacted by LifeLine’s support?

“I always think about a young girl in one of our HIV intervention programs. She had missed school and had not collected her medication. When our case worker visited her home, they found her mother had been severely abused and was unable to care for herself.”

Through LifeLine’s programs, the mother received counselling and enrolled in a training program for survivors of abuse. She learned how to make household detergents and started her own small business. This allowed her to leave her abusive partner, support her children, and regain her independence.

“None of this would have been possible without USAID funding, our programs, and our field workers. Now, with funding gone, these success stories will become fewer. Women and children in dangerous situations will have nowhere to turn, exacerbating the very social ills we work to prevent.”

Zoe Thomas is a writer currently studying her Masters in Journalism